You pull into the station after a grueling 24-hour shift. The cardiac arrest on scene turned into a dead on arrival. The child with the head injury wasn’t breathing when you arrived. Your last patient coded twice on the way to the emergency room (ER).
Now, as you sit in your car before heading home, you feel numb.
37% of EMS providers meet the clinical criteria for post-traumatic stress disorder (PTSD), compared to 6% of the general population.1
Depression and anxiety rates in EMS are 5–10 times higher than in other professions.2
EMS providers are 1.39 times more likely to die by suicide than the general population.3
Yet, mental health in EMS remains heavily stigmatized, forcing providers to suffer in silence.
The Reality of EMS Mental Health: What We’re Not Talking About
The stressors of EMS are relentless and cumulative. Unlike hospital-based clinicians, EMS personnel operate in unpredictable environments, with little control over what comes next.
1. The Accumulation of Trauma: PTSD in EMS
Daily, EMS providers encounter death, violence and suffering. Over time, these experiences re-wire the brain, leading to:
Hypervigilance – Constant alertness, even off duty.
Emotional numbness – Struggles connecting with family and friends.
A 2020 study found that first responders process trauma similarly to combat veterans, yet many do not seek help due to fear of judgment or job repercussions.4
2. The Burden of Depression and Anxiety
Long shifts, sleep deprivation, and workplace stress contribute to high rates of chronic depression in EMS.
Anxiety and panic attacks are frequently reported but often go untreated.
EMS providers with untreated depression are more likely to make critical medical errors on scene.5
3. The Suicide Epidemic in EMS
The harshest reality?
EMS providers are at higher risk of suicide than firefighters, police officers, and even military personnel.3
Many turn to substance use, alcohol, or isolation rather than professional support.
We are losing our own, and the system is doing little to stop it.
#James Donaldson notes: Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes. Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use. Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.#http://bit.ly/JamesMentalHealthArticle Find out more about the work I do on my 501c3 non-profit foundation website www.yourgiftoflife.org Order your copy of James Donaldson’s latest book, #CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy
“I don’t have time for therapy. I barely have time to sleep.”
EMS schedules are brutal—48-hour shifts, mandatory overtime, and chronic exhaustion make consistent mental healthcare nearly impossible.
“It’s just part of the job.”
The “tough-it-out” culture in EMS tells providers to suppress emotions and keep moving. But unprocessed trauma doesn’t disappear, it accumulates until it becomes unmanageable.
